A dermatological curet is well known in the art and comprises a slender handle that fits into the hand and a round cutting edge in the form of a sharp oval or circular curet that can be used for scooping out cavities in tissue or small pockets of tumor and for small lesions. A sharp shearing force is used by the physician. It can also be used for treatment of superficial growths on the skin, both benign and malignant. The curet is typically held like a pencil in the hand of the physician, who balances and steadies the hand holding the curet with the little finger, which rests on the patient's skin. The thumb and index fingers of the opposite hand stretch the skin on which the curet is to be used. Thus, three point traction to the skin on which the lesion is to be curetted is achieved. This traction creates tension and a firm surface, which permit the physician to curette more easily through soft tissue. The firmer the surface, the better the curet works. Once tension on the skin is attained, the curet is drawn through the lesion and toward the physician with a steady yet firm downward scooping motion. This mechanical action literally scrapes the lesion from the adjacent normal tissue. This mechanical curetting is often followed by an electrosurgical treatment with a bipolar electrode to seal off bleeding blood vessels.
The disadvantage of a mechanical action curet is that the skin surface needs to be firm. It is difficult or impossible to use a mechanical curet on soft unsupported skin tissue such as the eyelid. A second disadvantage is that although mechanical curetting of skin to separate diseased tissue from normal surrounding tissue was described as early as 1876, skin surgeons remained unconvinced that the mechanical curetting of skin alone could cure carcinomas of the skin. Therefore other destructive methods were performed after the curettage. These methods included the use of caustics such as acid nitrate of mercury, radiation, electrosurgical techniques such as electrodesiccation or electrocoagulation, and liquid nitrogen (cryosurgery). The electrosurgical schemes frequently used a pointed electrode to destroy any tumor cells left behind following the mechanical curetting of the lesion.